Avaliação da qualidade de vida em pacientes com artropatia do manguito rotador submetidos a artroplastia reversa do ombro

• Ano de defesa: 2018
• Autor(a) principal: Leite, Luiz Marcelo Bastos [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Rotator cuff arthropathy; Shoulder reverse prosthesis quality of life; Artropatia do manguito rotador; Ombro prótese reversa qualidade de vida
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6350777; https://repositorio.unifesp.br/handle/11600/52460

Introduction: Rotator cuff arthropathy (RCA) is defined as the combination of glenohumeral arthritis and massive rupture of the rotator cuff tendons or their deficiency. The patient presents pain, weakness, muscular atrophy, loss of strength, deficits in active and passive movement of the shoulder. The first treatment for RCA with shoulder arthroplasty was designed in the late 1800s, and with the evolution, new models of prostheses were developed as the reverse shoulder arthroplasty (RSA), described by Paul Grammont in 1985. There are some studies that report improvement in the quality of life and functionality after RSA. SF-36 is a tool (a 36-question-questionnaire) for assessing quality of life concerning physical and mental aspects, in addition to the biopsychosocial regarding health. There are few studies in the literature on health-related quality of life in patients with RCA operated on a reverse shoulder prosthesis with a follow-up lasting more than five years. Objective: It aims at evaluating the quality of life related to health and predictors of it in patients with RCA arthropathy submitted to a RSA. Method: A retrospective study followed by descriptive analysis of the series of cases. A total of 35 patients who underwent reverse prosthesis surgery from august 2007 to july 2015, in private hospitals in Salvador – Bahia (case by the author) were convened in the office in 2017 for review and application of the SF-36 questionnaire translated and validated. In all surgeries, the ARROW® prosthesis brand manufacturer FH France was used. The minimum follow-up time was two years and the maximum was 10 years with a mean of 5.25 years of postoperative follow-up. In the statistical analysis, the IBM SPSS version 18 software was used. Results: Among the 35 patients with AMR, 29 were female (82.9%) and six were male (17.1%); with an age range from 50 years to 89 with an average of 75.71 years. The dominant side was more frequently affected in 24 cases (68.6%). In relation to the classification of Hamada, 20 cases were Hamada type 3 (57.1%) and 15 cases Hamada 4 (42.9%). The Mackenzie approach was used in 30 patients (85.7%) whereas the deltopectoral approach in five patients (14.3%). As for the SF-36 standard scores with the eight domains, the Physical Health Component (PHC) scored 50.01 +/- 7.66 and the Mental Health Component (MHC) 54.05 +/- 9.03. Regarding the quality of life and time elapsed from surgery, patients up to 5 years had PHC 49.94 +/- 9.01 and MHC 53.72 +/- 9.34 and patients with > = five years of surgery had CSF 50.07 +/- 6.72 3 CSM 54.31 +/- 9.03. Regarding the Hamada classification and age when operated, of the 20 patients older than 75 years, 11 were Hamada 3 and 9 were Hamada 4, and of the 15 patients younger than 75 years, nine were Hamada 3 and six were Hamada 4. As for quality of life related to health considering age at surgery (greater than 75 years and less than 75 years), there was no statistically significant difference in PHC and MHC. Also regarding the health-related quality of life assessment considering the severity of the rotator cuff arthropathy (Hamada 3 or 4) there was no statistically significant difference in PHC and MSM. Conclusion: Patients with RCA undergoing RSA enjoy good health-related quality of life with improved pain and function. The good results of the technique are maintained over time without any tendency to reduction.